Category: Child / Adolescent - Depression

Symposium

Specific Life Stress Domains and Adolescent Suicide Attempts

Sunday, November 19
8:30 AM - 10:00 AM
Location: Sapphire 410, Level 4, Sapphire Level

Keywords: Suicide | Self-Injury | Stress
Presentation Type: Symposium

Suicidal thoughts and behaviors are prevalent among adolescent inpatients. While suicide ideation is a robust predictor of post-hospitalization attempts (Prinstein et al., 2008), only one-third of ideators make an attempt (Nock et al., 2013). Most strong correlates of suicide (e.g., depression) are relatively weak predictors of attempts among ideators; thus, identifying novel risk factors of the shift from suicidal thinking to behavior is critical. Life stress is unequivocally linked to suicide (Liu & Miller, 2014), but it is unclear which types of stress may be implicated in the transition from ideation to attempts. To address this gap, Study 1 recruited 216 hospitalized adolescents (135 female; Mage=15.59, SDage=1.45): 56 recent (i.e., past 6 months) attempters, 82 suicide ideators, and 78 non-ideators. Participants completed the Stress and Adversity Inventory (STRAIN; Slavich & Epel, 2010), an online measure of perceived life stress severity across 13 discrete domains (e.g., education, health) in the past 6 months. Attempters, ideators, and non-ideators differed in perceived stress severity in only two domains: Housing (e.g., poor living conditions), F(2,213)=5.99, p=.003, ηp2=.05, and Other Relationships (e.g., bullying; conflict with friends), F(2,213)=6.67, p=.002, ηp2=.06. In these domains, recent attempters reported more severe stress than both ideators (ps0.36) and non-ideators (ps0.39) who did not significantly differ (ps>.088, ds<.28)). In a second, ongoing project (Study 2), hospitalized ideators (n=20, target n=30) and attempters (n=21, target n=30) complete the STRAIN and the Life Events and Difficulties (LEDS), a rigorous, contextual interview and rating system that measures objective, rather than perceived, life stress severity. Analyses will test differences between ideators and attempters in stress severity across the 10 domains probed by both the STRAIN and LEDS and examine the concordance between these measures. Taken together, findings will clarify the types of stress most likely to trigger suicide attempts among high-risk youth, which may ultimately inform more targeted psychosocial interventions for adolescent suicide.

Jeremy G. Stewart

Instructor in Psychiatry and Assistant Neuroscientist
Harvard Medical School and McLean Hospital

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